Page 10 of The Night Shift
‘And your patients are very lucky to have such a caring doctor looking after them over Christmas,’ her father added warmly. ‘You make sure you’re looking after yourself too. Lots of love and Happy Christmas!’
Violet said goodbye and disconnected the call before the lump in her throat made her voice noticeably wobbly. She knew that her parents were proud of her. She knew they loved her and supported her unconditionally. And yet, she couldn’t share in their pride and enthusiasm. She desperately wanted to admit her true feelings but couldn’t bear the disappointment on their faces when they realised that their studious and high-achieving doctor-daughter was awaiting the outcome of not one, but two, active complaints against her, was rubbish at her job, and actually, didn’t like or understand patients very much.
Gus
Tuesday night
25th December– Christmas Night
Later that Christmas Day Gus was back at work reviewing a patient who had recently been moved to ward eleven and was now fast asleep. It was nine o’clock and the ward remained busy although festive visitors had been sent packing and most of the patients were dozing in their beds, some still wearing paper crowns or half-submerged under a sea of balled-up wrapping paper. He had noticed that the curtains were pulled around the bed opposite and he could hear the voice of Violet Winters as she clerked in a new admission who’d come through A&E. The patient she was talking to sounded very well spoken, elderly but not frail, and she and her husband were evidently very grateful to have been transferred so quickly. Gus listened in for a few moments while he reviewed the notes of the sleeping Mrs Grainger and jumped guiltily when he heard the sound of the curtain being pulled back, not that Violet could see him in the far corner, and not that it would have mattered if she had. He was supposed to be here, after all.
‘So, I’ll write up your medication and as soon as your blood test results are back, I’ll let you know,’ Violet said, her voice becoming clearer as she opened the curtain to the rest of the ward, toppling over a small floral suitcase in the process. A tired-looking gentleman sat beside the bed rescued the case and propped it back up before rubbing the bridge of his nose between thumb and forefinger. The woman in the bed was wearing a set of ironed pyjamas and a silk kimono. If it hadn’t been for the drip-stand and the polyester standard-issue blue blanket over her feet she would have looked as if she was on a luxury mini-break.
‘Derek,’ the woman said, talking to the man in the chair. ‘You’ll have to get my cleansing lotion out of the wash-bag so I can complete my ablutions.’ Turning to Violet, she smiled. ‘Thank you, dear,’ she said and then lowered her voice conspiratorially. ‘And may I just say how nice it was to see an English doctor at last! Honestly, you should have seen it down in the A&E department. I could barely understand a word they were all saying.’ She inclined her head in the direction of her husband. ‘I said to Derek, I said, Derek, it’s like being in the slums of Calcutta!’ She gave a tinkling laugh. ‘I’m not being racist, dear. We’re not racists, are we, Derek?’
Derek seemed to feel it best not to comment as his wife continued in her hushed tone.
‘I mean, one of my best friend’s nephews married an Asian girl so we’re very “au fait” with other cultures.’ She gave another tinkling laugh. ‘It’s just that it was such a relief to get up here and see you and think, phew! Someone who can speak the Queen’s English!’ She smiled again, evidently feeling that she had bestowed a significant compliment. Gus could see Violet’s shoulders tense briefly beneath her scrubs and then she turned to the woman.
‘I realise that you’re trying to be kind, Mrs Boulter.’ Violet’s voice was stern. ‘But actually, what you just said wasreally very racist. And I’m not comfortable with that kind of language in my workplace. In fact, I’m not very comfortable with that kind of language anywhere.’ She gave her patient a hard stare worthy of Paddington, and Mrs Boulter seemed to briefly shrink into her pillow before puffing herself back up and looking affronted.
‘Well, you’ve taken my comments entirely out of context, hasn’t she, Derek?’ She looked to her husband for confirmation. ‘And I can’t say that either of us are very impressed with being spoken to in such a manner. Hmmph!’ She folded her arms and looked expectantly towards Violet, waiting for an apology that Gus could see was not forthcoming. He stifled a grin behind his hand as he watched Violet gather up her notes and stride away from the bed without another word, cool as a cucumber.
Mrs Boulter continued to mutter with increasing volume about her blood pressure and how she was sure to have one of her turns and, ‘Goodness, Derek, fancy anyone calling me a racist– me! When I knitted those hats for the Afghani orphans!’ while her husband looked as though he wanted the ground to swallow him up.
‘I don’t think Derek’s Christmas Day is going according to plan,’ Gus said quietly when he found Violet writing up her notes at the nurses’ station a few moments later.
She looked up and laughed. ‘Oh, did you hear that? No. Poor Derek. Although I expect he’s used to things not going entirely his way.’
‘You did the right thing,’ Gus said. ‘Calling her out on it.’
‘I know,’ said Violet, she looked surprised that there would have been any suggestion she’d have done otherwise.
‘Yes, but there are some people who’d have taken the path of least resistance and just pretended they hadn’t understood, or sort of laughed along because they didn’t want to cause offence.’ As he said this Gus wondered if he was referring to himself and felt briefly ashamed for his theoretical lack of moral fibre.
‘Well, they’d have been wrong,’ said Violet simply. ‘That’s just collusion. If anything, it’s more important to call it out with those middle-class types, they’re the worst. Did you hear her? “How could I be racist, my friend’s married to an Asian!”’ She put on an imperious tone as she mimicked Mrs Boulter and they both started to laugh, Gus with a loud guffaw that he had to turn into a cough and Violet with noisy snorting giggles that she tried to smother with her hand until the tears leaked down her cheeks. After a moment they both caught their breath and then one of the nurses walking past gave them a curious look that started them back off all over again.
Eventually Violet’s giggling subsided and she returned to Mrs Boulter’s notes. ‘Well,’ she said, ‘racist or not, I think perhaps her ECG needs reviewing.’ She pulled the cardiac trace out of the file and showed it to Gus. ‘It was reported as okay down in A&E, other than her heart rate being a little fast, but I think those complexes look quite low voltage– do you see?’ She pointed to the zig-zagging line that indicated the main contraction of cardiac muscle. ‘And they’re alternating, high then low, then high again. I mean, it’s quite subtle,’ she squinted at the trace, ‘but it’s definitely there.’
‘Hmmmm,’ said Gus, peering over her shoulder and catching a waft of fresh citrussy fragrance as he did so. ‘How did she present?’
‘Just a bit of chest pain,’ said Violet, still absorbed by the cardiac trace. ‘But I think she might have some fluid around her heart. I’m going to go back and have another listen, see if I missed something, and then I’ll call Anjali. We need to arrange an echocardiogram.’
‘Good work,’ said Gus, impressed. ‘There are not many foundation year doctors who’d have picked up electrical alternans on an ECG. She may well have a pericardial effusion, you’re right.’
‘Thanks,’ said Violet, looking pleased. She pulled her stethoscope back out of her pocket. ‘I guess I’ll see you later?’
‘Hope so,’ he said. And meant it. He watched Violet heading back to Mrs Boulter’s bed, completely unphased by the crossed arms and disgruntled look on her patient’s face as she explained that she would need to have another quick listen to her heart. She caught his eye when she turned to pull the curtain back and he thought for a brief moment he could see a mischievous smile playing across her lips, but then she was gone.
There was something intriguing about Violet Winters, he mused as he left the ward– she was unlike anyone he’d ever met before, with her funny abrupt manner and her flashes of quirky humour. He was impressed by her clinical acumen but also by how she’d stood up to that patient. He liked her no-nonsense approach. In fact, there were a lot of things about Violet that he liked. If he hadn’t been a walking relationship-catastrophe he might have even considered asking her out for a drink.
Violet
‘If you could just write her up for a sleeping tablet? Something to knock her out for a while.’ The staff nurse thrust the drug chart under Violet’s nose, her expression terse.
Violet screwed up her eyebrows. ‘For Mrs Jenson?’ she said. ‘Is she usually on night sedation?’
‘I don’t know,’ said the nurse. ‘I’m not normally on this ward.’ She flicked the drug chart over as if it might offer some insight. ‘She didn’t come in with anything but she definitely needs something now. Just pop it down as a one-off dose and I’ll get one of the girls to?—’
